This application addresses broad Challenge Area (01) Behavior, Behavioral Change, and Prevention and specific Challenge Topic 15-MH-105 Strategies to support uptake of interventions within clinical and community settings. This proposal seeks to increase the number and caliber of trained Assisted Living staff caring for persons with dementia, in order to meet the needs of this vulnerable and underserved community. A well-established partnership of Aging Services of Washington, the leading organization representing not-for- profit long-term care and senior housing providers in the state of Washington and an experienced group of interdisciplinary researchers from the U.W. School of Nursing's NorthWest Research Group on Aging (NWRGA) will collaborate to develop, evaluate, and systematically translate an evidence-based training program designed to direct care staff in Assisted Living Residences to improve the care of older adults with cognitive impairments, increase the level of skill of their caregivers, and delay more costly institutionalization. At the end of the funding period, an infrastructure will exist to insure effective and wide-spread translation of this program to sustain effective quality services for the wider community. As the numbers of older adults with cognitive problems requiring care in this country increase, so does the need for well trained staff. Assisted living residences are currently estimated to provide care for over two million older adults, with over half experiencing significant cognitive, affective, and behavioral problems, and more entering every year. Despite this, there are insufficient numbers of individuals trained and employed to provide quality care to these vulnerable and underserved older adults. The uptake and translation of an effective empirically evaluated treatment to improve care, reduce affective and behavioral problems, and reduce transfer to more costly long-term care options will have a significant public health impact affecting millions of older adults now and millions more in the future. The specific aims are to: (1) increase the number of qualified trainers and direct care staff in Assisted living through the systematic and standardized dissemination of an evidence-based intervention;(2) establish and evaluate success of this dissemination using state-of-the- science methods for treatment fidelity;(3) evaluate program effectiveness in regards to trainer, direct care staff, and care-recipient outcomes including affective and behavioral disturbance, lower health care costs, satisfaction with training among trainers and caregivers, and improved care for residents;(4) develop the infrastructure to continue this training when the current program period is concluded. This proposal addresses an issue of significant public health interest - the reduction of affective and behavioral disturbances in persons with dementia in Assisted-living (AL) residences. Staff Training in Assisted-living Residences (STAR) is an evidenced-based, state-of-the-art treatment program with demonstrated efficacy in training AL staff to utilize behavioral problem solving techniques to reduce affective and behavioral disturbances and improve the lives of persons with dementia. The proposed project is a partnership between university researchers and a community organization to translate STAR for broader, national use.